Fusão renal

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2008 THE AUTHORS. JOURNAL COMPILATION Upper Urinary Tract KIDNEY FUSION ANOMALIES GLODNY et al.

2008 BJU INTERNATIONAL

BJUI
BJU INTERNATIONAL

Kidney fusion anomalies revisited: clinical and radiological analysis of 209 cases of crossed fused ectopia and horseshoe kidney
Bernhard Glodny, Johannes Petersen, Karin J. Hofmann, Claudia Schenk, Ralf Herwig*, Thomas Trieb, Christian Koppelstaetter†, Iris Steingruber and Peter Rehder‡
Departments of Radiology, †Nephrology and ‡Neurology, Innsbruck Medical University, Innsbruck, and *Urology, Medical University of Vienna, Vienna, Austria
Accepted for publication 15 May 2008 B.G. and J.P. contributed equally

Study Type – System Prevalence Study (retrospective cohort study) Level of Evidence 2b OBJECTIVE To analyse the morphological appearance of horseshoe kidneys (HKs) and crossed fused ectopia (CFE) and to assess the frequency and clinical significance of associated anomalies and diseases. PATIENTS AND METHODS The findings and images of 209 patients with fused kidneys (FKs) were reviewed; in all, 244 scans from computed tomography (CT), 233 ultrasonograms and 89 micturition cystourethrograms, urograms, magnetic resonance images and angiograms were taken.

RESULTS HKs (found in one of 474 abdominal CT scans) and CFEs (found in one of 3078 CT scans) showed a high variability of vasculature that could not be classified. However, some generalized conclusions were possible about the renal vasculature (430 arteries in 103 kidneys). Variants of the most cephalad artery of both sides were rare. The second artery on the right had a pre-caval course. The origins of vessels located further caudal were more ventral. CFEs were anatomically different from HKs with respect to lower position, greater axial rotation, smaller pelvic width, more caudal origin, and fewer vessels, but not in accompanying anomalies. Severe anomalies or malformations were found in